The Year of the Cat – Cuba 2013

DevelopingEM would like to introduce Mike Abernethy for the first of a series blog posts. Take it away Mike.

I’m Mike Abernethy MD.  I am an associate professor of Emergency Medicine and flight physician with the University of Wisconsin. I was one of the presenting faculty at DevelopingEM 2013 in Havana and I am very much looking forward to Brazil in September 2014!

I have been asked to help with some of the the social media aspects of DevelopingEM 2014.  I feel obliged because if it weren’t for social media (Twitter and #FOAMed) I would have never discovered this group of diverse, talented and dedicated physicians. I also would have missed out on one of the greatest experiences on my life – DevelopingEM13  in Havana Cuba.

Old dogs can learn new tricks. At the tender age of 55, #FOAMed has revolutionized the way I educate myself.  It has opened doors that I never knew existed. The end result is that I know I am a better physician and probably a better person. A perpetual work in progress. I hope you will have the same experience.

I’d love to relate not only my thoughts on the DevelopingEM 2013 educational experience but also my personal experiences in wonderful Cuba.

I hope that in a series of posts I can relate some of these experiences for all of you who couldn’t make it to Havana.

Flashback to January 2013

The conversation went something like this….

Me: Great news! Im going to be speaking at a Caribbean EM conference in the fall.

Wife: Oh , That’s great . Where?  Bahamas, Virgin Islands?

M: No, Havana Cuba.

W: I don’t think Americans are allowed to go to Cuba – Something about missiles, pigs and that embargo thing.

M: Its OK, The group has made arrangements with the American and Cuban governments.

W: Who is ‘The Group”?

M: Oh, the conference is sponsored by DevelopingEM, a group of international EM docs who are into global medical education. A really great group of people.

W: How did you get hooked up with them? Met them at a conference?

M: Well sort of –I met them on twitter, we’ve exchanged a lot of emails

W: Emails? The kind you find in the spam folder. “Dear Sir, You have won $1million in the Nigerian lottery”   You have never physically met them or spoke with them and you plan to accompany their entourage to a forbidden communist island nation. The honorarium must be pretty large.

M: Not exactly, They aren’t paying me and I sort of have to take care of my own travel, accommodations but they did promise an excellent conference venue. They have recruited some of the really big names in emergency medicine. Its quite an honor to be on the same program with some of these people. And they also promised a great time in Havana  you know, nightlife cigars and drinks.

W:  Lord, you are going to wake up in a bathtub full of ice with your kidneys gone. Have you updated the will?

Fortunately, as she found out more about DevelopingEM and their mission her attitude greatly changed. When the time came to go the wife was quite sad that she was unable to accompany me to Cuba due to prior commitments.

Fast forward 9 months – Monday  September 16th 2013

After a short 30 minute charter flight from Miami International airport, the wheels touchdown at Jose Marti airport outside of Havana. Cuba is so geographically close to the US just 2 weeks before, Diana Nyad swam the 110 miles from Havana to Key West Florida in 53 hours. But due to the Cold War hostilities and embargo –it might as well be 10,000 miles from the US.

There were no modern jetways –even for the larger aircraft arriving from Mexico and other Caribbean nations. Fortunately the weather was good. We got off the plane using stairs mounted on the back of what appeared to be an old Russian military truck and were herded across the tarmac in the 90 degree heat.  The airport terminal was a large single story building which looked like it was built in the 60s.

Once inside, the first thing I noticed was the presence of uniformed personnel everywhere. At first I thought they were all military but quickly realized that basically all airport employees wore what we would consider military style uniforms, complete with shoulder boards/epaulets. What caught my eye were the younger women who worked immigration They also wore a military uniform but with an above the knee skirt, fishnet stocking and heels. Nice touch!  All were fairly formal but polite and spoke some English.

After a 30 minute wait I was reunited with my suitcase. The line leading to immigration/customs went surprisingly quick until it was my turn. A rather stern faced young officer examined my passport and visa. After checking something on the computer, he asked me to step into a side room. Two folding chairs, a table and a single light bulb hanging from the ceiling. This is the stuff that happens in really bad B grade detective movies. I mentally reviewed my rather “colourful” teens and twenties trying to think what offence might trigger this interrogation 35 years later. I came up with a few valid possibilities but then realized, how the hell would the Cubans know about the cement mixer misunderstanding in Youngstown Ohio in 1979?  Or my brief stint in a Juarez Mexico jail back in 81?  Or maybe the infamous Spiderman incident in Cincinnati?  No they couldn’t…. or could they?  How?     Damn Wiki leaks.

The officer rapid fired a few questions regarding the nature of my occupation and my reasons for coming to Cuba. I explained about DevelopingEM and handed him literature from the web page. He asked me where I lived and also if I had ever served in the US military. I answered questions all of his questions. He abruptly stood up and told me to stay seated. He walked into the next room . This doesn’t seem to be going well. Flashbacks to Juarez. He returned a few minutes later, handed me my passport and pointed me towards the exit.  Just as I reach the door I hear “Doctor, STOP”.  Fearing the worst I immediately halted and turned around. He walked up to me and for the first time in our encounter I saw smile. He shook my hand ”Sir, thank you for coming to my country. I am glad for what you will teach but I hope you also learn a lot about us”.

Crisis averted. Next step, navigate my way to downtown Havana from the airport with my Spanish limited to 2 phrases – . ¿Dónde está el baño and  por favor déme dos cervezas más. For the first time in my life I sincerely regret sleeping through Ms Sefferas high school Spanish class. I was relieved (and impressed) to find out that a majority of Cubans I encountered spoke at least a little English.

The drop off area in front the airport was quite chaotic  by American standards.  I imagine it is like this most of the time.  I am not sure what constitutes an actual taxi in Cuba. There is no real licensing or placard indicating car for higher on most of them. Fortunately I knew the ride from the airport should cost about $25. The first encounter was with a gentleman driving a beat up nondescript Russian sedan from the 1980s. He offered me what he deemed a good price at $70. I offered 20 and he acted quite offended. After haggling back and forth for a few minutes we agreed on $30. Shortly after we started off, I heard a strange noise and commotion from behind my rear seat. The driver started to laugh. “Is OK, that’s my cousins chickens in the trunk”.  We drive for 30 minutes through run down outskirts of Havana until we reach the city. Im thinking “What the hell did I get myself into?” As we enter the city the scenery begins to change. Majestic buildings, monuments in various states of repair.

The cab dropped me off in front of the beautiful Hotel Nacional de Cuban, a well-maintained national treasure right out of the 1930s. Looking up and down the street, I now realized what people meant when they spoke about Havana being stuck in a different time. The cars, the people, the buildings , the streets and how they all interacted.

I had arrived just in time to make the opening reception for DevelopingEM being held in one of the grand ballrooms. The actual conference hotel was about 3 miles away and I didn’t have time to check in. I walked into the ballroom, dragging my suitcase and backpack and parked my gear in a corner.  I was immediately greeted by a waiter with a tray of the traditional Cuban rum drink –The Mojito. After two or three of those – the stress of the last few hours seemed to melt away.    I sat alone for 15 minutes or so soaking in the atmosphere and the music. Its time to socialize. Although I have been corresponding by e-mail and twitter regarding the organizational aspects of the conference, I suddenly realized that I have never physically met a single person out of the 200 or so people at this reception. I have no idea what anyone looks like. Thank god for name tags.  My apprehension was short lived.  In a matter of minutes I was putting names to the faces.  I am greeted by many of the international faculty like an old friend. As the evening went on everyone spilled out onto the veranda and bars adjacent to the ballroom.  Drinking Mojitos and smoking cigars while exchanging EM war stories. A 12 piece Cuban band is playing Guantanamera in an arrangement that almost brought tears to my eyes. My father was a musician in his younger years but maintained an appreciation for all music genres throughout his life – as long as it was done with some soul and skill. I grew up listening to everything from Bach to Glen Miller to Dylan and as a result, share his eclectic tastes. Dad was fascinated and very proud that I was making a trip to this long “forbidden” country. Unfortunately he died just a few weeks before I left after a year long battle with cancer. Listening to the wonderful music, all I could think was “I wish Dad could be here to see this”.
But then I realized –In many ways, he was

As the evening drew to an end, I headed to the hotel entrance with my gear in tow. One of the delegates, who had spent time in Havana, asked me if I was headed back to the Melia Cohiba, the hotel where the conference would be held.  I thought he wanted to split a cab. Lets walk, its only about 2 miles. Sure.  So there we were, 2 obvious turistas walking the backstreets of Havana on a hot autumn night. These were some pretty run down neighborhoods with many of the locals sitting on the stoop in front of their buildings. Looking closer, much of the architecture was magnificent but grossly neglected. I just imagined what this place must have been like in the 1930s . Given a similar neighborhood in Chicago or Miami, we wouldn’t have lasted 5 minutes before being relieved of our earthly possessions. Although there were quite a few locals out and about, we never felt threatened or had a reason to be. There were a couple of invitations to come into what I think was a home based bar and/or restaurant. We politely declined.  I also noticed a uniformed police officer about every block.

We arrived at the Melia Cohiba unscathed after our 40 minute backstreet tour. It was also quite a surprise. It is a beautiful modern hotel and conference center that would rival any four star Florida beach resort. We had a beer in the hotel bar and went our separate ways after checking in.  After unpacking, I put on a t shirt and changed into my jeans. I went downstairs and had another beer. I purchased a few Cuban cigars ( banned in the US), my very first. I lit up and then took a walk through one of the nearby neighborhoods where there was some kind of street party going on. Between the lack of street lights and the music I was able to anonymously blend into the scenery. I sat on a railing, smoking my fine cigar watching a group of 50-60 people having a marvelous time singing and dancing in the street to the music of a few guitars and drums.

The lyrics from a 70s song “Year of the Cat” came to mind

On a morning from a Bogart movie
In a country where they turn back time
You go strolling through the crowd like Peter Lorre
Contemplating a crime

When I got back to the hotel, I asked the doorman what exactly was the reason for the street party down the block. He had a wide grin with one gold tooth. “Oh that’s easy my friend, Its Monday. You know it only comes once every seven days”.

I am 100 miles from Key West, Florida but I am definitely in a foreign country- in a different era.  This place has not arrived into new millennium-and that is not a bad thing.

So this is Cuba. I am starting to really like this country.

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